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Characteristics and etiology of infection in febrile infants aged ≤90 days

Yuhei Tanaka1,2, Ippei Miyata2, Yoshitaka Nakamura2

  • 1Department of Pediatrics and Child Health, Kurume University of Medicine, Kurume, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|October 27, 2021
PubMed

Insights

Serious bacterial infections (SBIs) in infants under 90 days can present with subtle signs. Higher white blood cell counts and absolute neutrophil counts, with fewer respiratory symptoms, may indicate SBI in these young children.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Infants ≤90 days old often show non-specific signs of infection, complicating diagnosis of serious bacterial infections (SBI).
  • Early identification of SBI in neonates and young infants is critical for timely and effective treatment.

Purpose of the Study:

  • To investigate clinical and laboratory markers differentiating serious bacterial infections (SBI) from other infections in febrile infants ≤90 days old.
  • To explore the role of viral detection in nasopharyngeal swabs and family respiratory symptoms in relation to SBI.

Main Methods:

  • Prospective study of 110 febrile infants ≤90 days old hospitalized between June 2017 and August 2019.
  • Utilized multiplex real-time PCR and 16S rRNA analysis for microbial identification.
  • Collected data on inflammatory markers, maximum body temperature, and respiratory symptoms in infants and their families.

Main Results:

  • 17% of enrolled infants had SBIs. Infants with SBIs had significantly higher white blood cell (WBC) counts and absolute neutrophil counts (ANC) compared to non-SBI cases.
  • Maximum body temperature (BT) did not significantly differ between SBI and non-SBI groups.
  • Viruses were detected in 74.5% of infants; viral detection was more frequent in infants with respiratory symptoms. Notably, infants with SBIs had fewer respiratory symptoms than those without (P=0.049).

Conclusions:

  • Elevated WBC count and ANC, coupled with diminished respiratory symptoms, are significant indicators of SBI in infants ≤90 days old.
  • Nasopharyngeal multiplex PCR results were insufficient to definitively diagnose SBI or non-SBI.
  • Further research is needed to refine diagnostic criteria for SBI in this vulnerable population.
Abstract

Keywords:
bacterial infectionbody temperaturefebrile infantsfeverviral infection

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